NA 1 > NORA > Flashcards

NORA Flashcards

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1
Q

What percent of procedures are outside of the OR?

A

55%

mean age older by 3.5 years in NORA

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2
Q

Patient specific conditions that require vigilance

A

Mental impairment, GERD, OSA, decreased LOC, depressed airway reflexes, difficult airway/abnormalities, URI, morbid obesity, procedures impeding airway access, procedures complex, lengthy, painful, positioning complex, trauma, extremes of age, prematurity ASA III,IV

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3
Q

Policies and procedures in NORA

A

NON OPERATING room safety checklist

requires same level of safety and high standards

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4
Q

challenges in NORA

A

limited access to airway and equipment

hemodynamic instability

radiation exposure

contrast induced nephropathy

electromagnetic interference

emergency preparedness

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5
Q

AANA standards for NA practice

A

Standard 2: Preanesthesia Patient Assessment and Evaluation
Standard 3: Plan for Anesthesia Care
Standard 4: Informed Consent for Anesthesia Care and Related Services
Standard 5: Documentation
Standard 7: Anesthesia Plan Implementation and Management
Standard 9: Monitoring , Alarms
Standard 11: Transfer of Care
Medication management- prepare, dispense, label meds to be used for the patient
Adhere to safety precautions and protocols of organization
Minimize risk to patient, operator and ancillary staff

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6
Q

Requisites for administration of anesthesia in remote locations:

A

anesthesia cart
reliable O2/backup (Minimum of 2 sources)
reliable suction
reliable scavenging if gas
Self-inflating resusc bag (FiO2 90%

Adequate drugs, supplies, equipment for planned activity and backup

monitoring equipment to adhere to basic anes. monitoring

sufficient electrical outlets - isolated electric power or electric circuits with ground fault interruption in wet areas like cystocopy, arhtroscopy, labor/d

sufficent space and personal transportation

immediate assess to code/defib/drugs

difficult airway cart, MH, reliable communication, appropriate postanesthesia management

documentation

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7
Q

Who is at risk for adverse events in NORA?

A

elderly and medically complex

GI, CV, ER = most likely to have adverse event

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8
Q

What is the most common adverse event?

A

Resp depression secondary to oversedation

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9
Q

Minor adverse events in nora:

A

PONV
Pain
Hemodynamic instability
PDPH
Need for opioid reversal
minor resp compl.
compl r/t central/intravenous line

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10
Q

Major adverse events in nora

A

Unintended awareness, anaphylaxis, serious hemodynamic instability, major respiratory complications, need for resuscitation, vascular access complications, wrong site, fall, burn, central or peripheral nervous system injury

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11
Q
A

MAC, general, regional appropriate
Various methods of sedation
Enteral, rectal, parental, inhaled
Depth of sedation is a continuum > patient may progress quickly from one level to another > BE VIGILANT and ready to respond

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12
Q

Geriatric special considerations (LIST)

A

loss of functional reserve

comorbidities: Atherosclerosis, infection, autoimmune disease chronic disorders, cancer

immune system decline - inability to fight foreign bacteria, viruses

increased ratio of adipose tissue to aqueous body tissue = store lipid soluble drugs

Decrease BMR, kidney, liver, physical activity, cardiac function, tissue oxygenation, lung compliance, thermoregulation

cerebral atrophy –> more sensitive to anesthetics - increased risk of delirium/confusion postop

skeletal muscle diminished

inability to respond to hypoxia/hypercarbia

decreasd immune system

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13
Q

Special considerations of pediatric:

A

unique challenges
PRIMARY concern = patient safety

plan communicated to parents/guardians and pt

adverse events = respiratory depression, obstruction, apnea

Drug erros, bradycardia, laryngospasm, vomiting, aspiration, diarrhea, hypotension, inadequate/prolonged sedation

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14
Q

Anesthetic considerations of pediatrics:

A

PMH - previous response to anesthesia/family hx

ASSESS for recent URI (HIGH RISK OF REACTIVE AIRWAY), fever, cough, snoring, sputum

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15
Q

NPO for pediatrics clears and solids age group

A

clear - 2 hours before sx
Food:
<6 mon = 4-6 hours
6-36mon = 6 hours
>36 mon = 6-8 hours

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16
Q

what must know with pacemaker

A

Type
indication
manufacturer
basic function
programmability
battery life
response to magnet
device limitation

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17
Q
A
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18
Q

Implantable pacemaker contains what?

A

Pulse generator - positioned in pectoral pocket

insulated lead wires - upt to 3 lead wires in RA, RV, Both RA and RV, or RA and both ventricles
- unipolar, bipolar (lower risk of EMI interference), multipolar

Sensing and capturing responses
RA spike followed by P wave on ECG = atrial depolarization
RV - spike followed by QRS on ECG = ventricular depolarization
Dual chamber - spike before P wave and before QRS = both atrial and ventricular depolarizations

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19
Q

External pacing pads placement:

A
  1. anteriorly on the right upper chest and anteriorly onthe left lower chest
  2. anteriorly mid-chest and posteriorly between the scapulae and plugged into defib/pacing machine
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20
Q

Transvenous pacing:

A

Catheter passed into central circulation to appropriate chamber and connected to externa PM generator

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21
Q

Epicardial pacing leads:

A

Sewn into epicardium by surgeon and attached to external pacing device

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22
Q

What is PM indicated for?

A

SA node dysfunction
AV node dysfunction
Bi-fasicular block
Long QT syndrome
HOCM
DCM
Post MI
Carotid sinus syndrome

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23
Q

EMI may cause PM to –

A

inaccurately sense intrinsic activity resulting in PM inhibition

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24
Q

3-5 letter HRS code
position 1

A

Chamber paced (chamber where pacing electrode paced)

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25
3-5 letter HRS code position 2
chamber sensed (chamber where the sensing electrode is placed)
26
3-5 letter HRS code position 3
response to sensing (PM response to detection of a spontaneous cardiac depolarization and its effect on subsequent pacing stimuli)
27
3-5 letter HRS code position 4
Programmability (rate modulation - rate adaptive sensor in generator programmed to respond to physiologic stimuli - compensate for physical needs, illness, stress)
28
3-5 letter HRS code position 5
Multisite pacing
29
30
ICD indications
VT VF Post MI with EF <35 CM with EF <35 HypertrophicCM waiting transplant long QT syndrome
31
Fx of ICD and what does it contain?
Restore regular and coordinated rhythm from lethal tachyarrhythmia contains: -pulse generator -battery -voltage capacitor -lead wire -shock coil
32
ICD where is it implanted?
Pectoral pocket on R or L
33
Anesthetic for ICD placement:
LA, MAC, GA
34
ICD coil placement and how it works
lead and shock coil attached to pulse generator and placed in RA and RV capacitor delivers current for defib by receiving energy transferred form generator's battery and discharging this energy as an electrical impulse impulse travels through lead/shock coil to myocardium and cardioverts or defib the heart
35
ICD RA lead fx:
Treat bradycardia provide rate modulation anti-tachycardia pacing cardiovert
36
RV lead ICD fx
treat vent. arrhythmia initiate anti/cardiac pacing Cardiovert and defib Treat bradycardia
37
ICD position 1
shock chambers
38
ICD position 2
anti tachycardia pacing chambers
39
ICD position 3
tachycardia detection
40
Position 4 ICD
anti bradycardia pacing chambers
41
42
EMI and PM
may interpret EMI as intrinsic electiv activity and inhibit pacing (Life threatening if reliance)
43
EMI and ICD:
interpret signal as potential tachyarrhythmias and deliver unnecessary shock
44
what is cardioversion?
Discharge of electrical energy synchronized to R wave - closes an excitable gap in myocardium, causing currents to reenter and excite the electrical system of the heart
45
What is cardioversion indicated for?
Hemodynamically unstable SV arrhythmias atrial flutter A- fib Stable VT
46
Which rhythms are associated with CHF and thromboemboli?
Afib andn aflutter
47
What procedure prior to CV excludes atrial thrombus?
TEE
48
What is the optimal shock dose for cardioversion:
50-100J via defibrillator pads or paddles with gel pad placement: parasternal over second and third intercostal space and apex of the heart
49
Cardioversion anesthetic considerations:
Usually planned procedure pt optimized and NPO Standard monitors emergency drugs/equip oxygen
50
Drugs for cardioversion:
Mod sedation acceptable Midazolam prop/etomidate NO muscle relaxants or opioids
51
What is radiofrequency catheter ablation?
Catheter with electrode at tip is guided under fluoroscopy to heart muscle that has accessory electrical conductive pathway EP studies used to determine origin and pathway of arrhythmia before RFCA left and right accessory pathways may be ablated (left most common)
52
Other tx of RFCA:
SA node or AV node mods Ablation of atrial flutter and atrial tachyarrhythmia ablation of focal atrial fibrillation and VT foci
53
PCI where is it performed?
Cath lab X-ray/fluro - as low as reasonably possible IV contrast heart accessed through fem, brachial, radial artery
54
Anesthetic considerations with PCI:
access to help iv moderate to GA plus LA at site vigilance for: SV arrhythmias, vent. arrythmias, hemorrhage, pain, anaphylaxis, vasovagal response, cardiac arrest, thrombotic events, hemodynamic instability, hypotension/hypertension
55
postop for PCI:
telemetry unit monitoring for dysrhythmias, fluid status, PONV, hemodynamic status
56
GI procedures anesthetic considerations:
Anesthetic services improves pt satisfaction and outcomes cause discomfort and pt motionless complete H and P
57
Anesthetic considerations with NPO and GI procedures:
Greater risk of aspiration due to pathology in GI tract and introduction of invasive endoscopy equipment
58
Colonscopy required bowel prep leads to:
Abd cramping diarrhea weakness nausea require IV with LR or NS
59
EGD/EUS special attention:
to CV history HTN bleeding nausea dysphagia GERD hallow oral airway into mouth
60
Upper endoscopy considerations:
consider preemptive analgesia with viscious lidocaine or atomizer may reduce gag consider antisialagogue (glycopyrrolate)
61
ERCP considerations:
review lab values and anticoagulant medication (generally more ill population): prone/semi-prone/ slightly left lateral position --> compromises airway (Consider GA OETT); assess neck ROM (Extreme lateral rotation) Peds - deep IV sedation or GA OETT; EMLA for IV placement
62
GI procedures Anesthetic considerations:
Standard monitors oxygen left lateral decubitus or supine risk of strong vagal nerve stimulation resulting in hypotension, bradydysrhythmias, ECG changes
63
Complications of GI procedures:
Vomiting aspiration laryngospasm bleeding bradycardia (vagal stim) hypotension bowel rupture duct rupture must be ready for airway intervention and hemodynamic support
64
Postop care for colonoscopy
Encouraged to pass flatus, monitor for rectal bleeding, nausea, hypotension, dehydration, vomiting give fluid and antiemetic
65
Postop care for EGD
bleeding, nausea, vomiting, aspiration, dysphagia, hypotension
66
ERCP postop care:
reaction to iodinated contrast
67
Mild reaction to iodinated contrast:
N/V pruritus diaphoresis flushing urticaria
68
Moderate reaction to iodinated contrast:
Faintness severe vomiting pofound urticaria mild bronchospasm mild hypotension mild tachycardia bradycardia
69
Severe reaction to iodine:
Hypotensive shock angioedema resp arrest cardiac arrest convulsions death
70
IVF stages:
Oocyte retrieval - 20-30 mins - short acting anesthetic with minimal side effects - conscious sedation (non anesthesia provider_, MAC, GA, regional, paracervical block, neuraxial, TIVA fertilization of the egg in a lab transfer of embryo back into uterus through cervix
71
requirements for IVF procddure:
remain still during retrieval and transfer reduce pain and anxiety
72
Aneshthetics for IVF
Agents in follicular fluid and adversely affect oocyte fertilization and embryonic development MAC is good option prop drug of choice (short DOA and antiemetic)
73
Drugs to avoid in IVF:
Morphine NSAIDs Metocopramide Sevo - Des
74
Safe drugs with IVF
Iso Ketamine Midazolam
75
Hysteroscopy procedure purpose:
Diagnose endometrial hyperplasia facilitates biopsy or withdrawal under visualization
76
Risks with hysteroscopy:
Pain nausea bleeding infection uterine perf
77
Hysteroscopy solution for distention?
Saline and CO2
78
Gynecologic procedures andn pain
Cervical dilation Painful recommend LA vasovagal reactions common when in cervical canal
79
Anesthetic techniques for gyn procedures
paracervical block with MAC GA Give NSAIDs (reduces pain and cramping but monitor for bleeding)
80
Anesthetic considerations for dental procedures:
Off site or office based airway shared with surgeon potential for heavy bleeding due to H/neck region small instruments with potential aspiration (Burs, implants) Dental prosthetics may affect the airway intense pain (maxillary and mandibular divisions of trigeminal nerve) anxiety
81
Anesthetic choice for dental procedures:
minimal to general Glyco - reduce salivation LA with epi nasal intubation common
82
End of procedure dental considerations:
Remove pharyngeal packs and the stomach suctioned at end of procedure antiemetics ensure adequate pain management fully awake extubation
83
Postop complications for dental procedures:
swelling bleeding N/V vasovagal response
84
Risks of nasal intubations:
Epistaxis bacteremia post. pharyngeal wall laceration false passage in hypopharynx obstruction from tissue from interior turbinate cuff rupture while insertion through turbinates axillary sinusistis otitis
85
contraindications of Nasal intubations
CSF leak Le Fort II fracture basal skulll frac (LFIII) nasal foreign body trauma to nasopharynx relative - coagulopathy, cardiac valve disease, immunocompromised
86
what to do prior to nasoal intubation:
identify more patent passage administer vasoconstrictors to both sides and use LA lubricant dilate with airway or red rubber
87
After induction and before laryngoscopy, how to perform the intubation nasally?
Place ETT in selected nostril and advance tube parallel to the palate advance the tube along floor of hte nose under inferior turbinate (lower pathway) resistance felt until deep posterior when a "give" is felt as tube passes the inferior turbinate, stop tube advancement for laryngoscopy when in pharynx may use MacGill forceps guide tub into trachea
88
Tape with nasal intubations:
Secure tape around head just above ears be aware of head movement, could compromise placement of the tube
89
Pediatric dentistry anesthetic choice:
MAC to GA - pt may be behaviorally uncooperative, immature, frightened, mentally disables immobilization board = papoose board (safety restraints)
90
Anesthetic techniques with pediatric dentistry:
Premedication - oral midazolam dissolved in tylenol, ibuprofen ,aspirin, low sugar clear juice intranasal or rectal midazolam oral or IM ketamine oral chloral hydrate, narcotic, midazolam prop inhaled or IV induction oral or nasal ETT
91
Oral and maxillofacial sx
Dx and tx of diseases, injuries and deficits of both functional and aesthetic aspects of hard and soft tissues oral and maxillofacial region ortho, extractions, tx of infections of head/neck, implants, alveolar bone remodeling, tumor removal
92
Risks of oral and maxillofacial surgery:
Severe pain and heavy bleeding
93
Anesthetic techniques with oral and maxillofacial sx:
LA with MAC (midazolam, prop) Inhalation sedation anesthesia (N20) inhaled anesthesia via ETT TIVA Remifentanil
94
Periodontics what is it?
Sx of teeth, gingiva, connective tissue, periodontal ligament, alveolar bond, implants prevention, dx and tx of support and surrounding tissues of teeth
95
Risks with periodontics:
painful and blood loss
96
Anesthetic technieques with periodontics:
LA with epi (hemostasis) MAC (minimal to moderate sedation with IV or inhalation agents) midazolam and prop
97
Endodontics sx purpose:
Dx, prevent, tx diseases and injure of pulp and periradicular conditions
98
Anesthetic techniques of endodontics:
LA with epi (hemostasis MAC (minimal to moderate sedation with IV or inhalation agents midazolam and prop
99
post anesthesia care for dental procedures:
morbidity low maintain IV analgesic and antiemetic drugs - long acting opioids, ketorolac, zofran
100
Risks for dental procedures:
PONV bleeding Peds patients often crying nausea vomiting
101
Precautions to limit exposure to radiation:
-limit the time of exposure to radiation -increase the distance from the source of radiation (dose rates are proportionate to the inverse square distance from the source) -use protective shielfding (lead lined garments, shields, thyroid shields, leaded eyeglasses -measure occupational exposure to radiation - Dosimeter
102
CT scan
x ray generated from rotating anode x-ray generator creating a detailed cross sectional images of the body -produces high resolution images that distinguishes between tissues, bones, and blood vessels (excellent for imaging bone and good for acute condtions) -contrast media containing iodine may be administered entarlly or parenterally
103
what is contraindicated with CT:
pregnancy exposes patient and provider to greater amoung of ionizing radiation
104
anesthetic considerations for CT:
motionless lies on flat/lightly padded wheeled platform unable to tolerate extremes of age, medical conditions, mental disability, claustrophobia radiation protection required
105
Anesthesia for CT:
minimal sedation to GA prop good choice avoid drugs causing myoclonus such as etomidate and methohexital vigilance required for airway/lines being placed into scanner
106
Iondinated contrast media use:
Used to enhance visibility of internal structures and improve diagnostic accuracy water soluble, iodine containing solution classified based on osmolality and ionic properties
107
What can happen is contrast media extravasates?
tissue sloughing and necrosis
108
Iodine contrast media is contraindicated in:
Pregnant patients
109
ICM recommendation:
use smallest dose adequately hydrate
110
Immediate reaction with ICM:
pruritic urticaria hypersensitivity
111
Risk of anaphylactoid reaction with ICM --
pretreat with CORTICOSTEROIDS (methylprednisolone/prednisone)
112
Risk of moderate/severe reaction with ICM:
H1 blocker and H2 blocker
113
Contrast induced nephropathy definition:
increase in serum creat of 0.5 or 25% increase from baseline within 48-72 hours CKD most importnat predictor risk factors: renal disease, prior renal sx, proteinuria, DM, HTN, gout, nephrotoxic drugs
114
Preventative measures for contrast induced nephropathy:
low osmolality contrast adequate hydration maintain good UO sodium bicarb infusion to improve elimination avoid nephrotic meds 24-48 hours before and after contrast - NSAIDs, aminoglycosides, diuretics
115
MRI how does it work
Uses strong magenetic fields and radiofrequency pulses to generate detailed images of internal structures of the body aligns protons in the body with a magnetic field then using radiofrequency pulses to disturb this alignment --> emitted signals are captured and processes to creased images
116
What is MRI good for?
soft tissue contrast (Brain, spinal cord, joints)
117
Contrast for MRI
Gadopenetate dimeglumine which contains gadolinium Gadolinium is a paramagnetic agent --> lower risk of alergic reaction, urticaria and anphylactoid reaction < 1% of patients (higher risk with asthma or allergies/drug sensitivities) Risk of NAUSEA generally safe but may be nephrotoxic in patients with severe renal impairment
118
What must you remove for MRI?
Ferromagnetic objects (eyeglasses, jewelry, watches, pagers, computers, phones, name badges, credit cards)
119
what are safe metals for MRI?
stainless steel nonferrous alloys nickel titanium
120
Risk of peripheral nerve stimulation with MRI -->
sensory phenomena ranging from mild tingling to intolerable pain
121
zone 1 MRI:
freelyu accessible to general public
122
zone 2 mri
area between uncontrolled zone 1 and strictly controlled zone III patient greeted, questions answered, movement by non-MRI personnel and pt is under supervision
123
Zone 3 mri
restricted area; movement strictly controlled by MRI personnel FERROMAGNETIC objects must be removed
124
Zone 4 mri
MRI scanner room
125
Anesthetic considerations for MRI:
Assess for potentially harmful items - AICD/PM - MAY BE REPROGRAMMED, inhibited, switched to asynchronous mode, dislodged, heated Metallic implants (ortho implants within 3 months) Pt must remain still
126
Radiofrequency field generated by strong magnetic field can produce what?
small voltage changes in blood that causes ST-T wave changes in ECG and decrease in blood flow with BP compensation by rising vertigo, Nausea, headache, peripheral nerve stim, metallic taste loud vibraion and knocking (ear plugs)
127
Anesthetic choice for MRI:
minimal sedation to GA (LMA) ONLY use MRI compatible equipment directly in MRI suite - Machine, monitor, laryngoscope blades/handle, IV polse, infusion pump, o2 tanks
128
Equipment needs for MRI
long circuits or extenders; long IV tubing avoid leads or IV tubing touching skin and ensure in straight line --> current flow in coiled leads/tubing results in BURN triple check circuit
129
What must occur thorughout the MRI for patient safety?
Clear continual view of pt with glass window audible and visible alarms
130
what is a PET scan?
Proton emissino tomography scan non invasive nuclear imaging technique providing insight into metabolic and molecular activity
131
what does PET scan detect?
malignant diseases neuro function CV disease
132
what is injected with PET scan?
Isotope fluorodeoxyglucose/ fluorine - 18 fluorodeoxyglucose (FDG) is injected and absorbed into metabolicaly active cells - highlights area of glucose metabolism isotope emits signals which are detected and produced high resolution images
133
What must occur after injection for PET scan?
still for 1 hour MUST be fasted to minimize blood glucose levels
134
What is TIPS procedure?
Transjugular intrahepatic portosystemic shung connection btw hepatic portal and systemic circulation created via percutaneous catheter inserted inthe internal jugular vein directed to the liver Decompresses portal circulation with portal hypertension reduces bleeding from varices and controls refractory cirrhotic ascites
135
Duration of TIPS procedure?
2-3 hours usually a bridge until transplant sedation or GA
136
what is IR?
subspecialty of radiolgy that uses image-guided, minimally invasive procedures to diagnose and tx various medical conditions Uses fluro, US, CT, MRI to guide shorter hospital stays compared to sx methods
137
Procedures in IR?
Angiography Embolization of BV's vascular occlusive devices removal of thrombi aneurysm ablation angioplasty BV
138
what is radiation therapy?
Tx of tumors sx - delivery of a single massive dose of radiation to target tissue radiation therapy - deliver of smaller doses of radiation over several sessions
139
Gamma knife or radiation/cyber knife:
uses beans of gamma rays from radioactive decay of cobalt 60 or from a linear accelerator
140
Interventional neuroradialogy purpose:
Dx and Tx of CNS diseases endovascularly to deliver therapeutic meds or devices
141
Procedures of interventional neuroradiology:
Mechanical or chemical removal of emboli or thrombi that can cause stroke physical occlusion of malformed vascular structures (AVM) dilation of stenotic blood vessels Embolization of aneurysm (coils)
142
Anesthetic considerations for IR/radiotherapy/sx/ neuroradiology:
Require immobility controlled apnea time consuming painful elective or emergent hemorrhage risk of HA, NV, vascular pain, radiocontrast reactions, perforation aneurysm/arteries --> may require transfer to OR
143
What is ECT?
Intentional inducement of generalized seizure of CNS for an adequate duration of time to treat patients with severe neuropsychiatric disorder (depression, mania, catatonia, vegetative dysregulation suicidal, schizophrenia, Parkinson's)
144
where are electrodes placed for ECT?
with conducting gel on right unilateral, bitemporal, or bifrontal alternating current of electicity passed through electrodes
145
Theoroes with ECT
Profound changes in brain chemistry such as enhancement of dopaminergic, serotonergic, and adrenergic neurotransmission Release of hypothalamic or pituitary hormones with antidepressant effects Anticonvulsant effects that raise seizure threshold and decrease seizure duration
146
Physiologic effects of ECT:
PARASYMPATHETIC during tonic phase - bradycardia, hypotension, brady-dysrhythmia SYMPATHETIC during clonic phase - tachy, HTN, tachydysrhythmias Increased CBF, ICP, IOP, intragastric pressure, hypovent
147
148
ECT anesthetic considerations: dosing
Brief GA -Glyco - 0.005mg/kg IV Etomidate - 0.15-.3mg/kg Ket - 0.5-1mg/kg methohex: .5-1mg/kg prop - 0.75-1.5mgkg Succ - 0.5-1mg/kg roc - 0.3-0.9mg/kg
149
Abslute contraindiactions for ECT:
Pheo recent MI <4-6 wks recent CVA <3 months recent intracranial sx <3mo intracranial mass unstable cervical spine
150
ECT and antidepressant therapy:
Lithiuum prolongs DOA of succ and NDMR Pateitns on MAOI's who receive indirect acting sympathomimetics are at risk of HTN crisis
151
What with monitoring shortens seizure duration?
Hypoxia and hypercarbia
152
Induction steps with ECT:
Methohexital --> etomidate or ketamine (Both maintain seizure quality) or Prop place bite block Psych applies TQ to leg so MR cannot reach in order to assess Succ induce seizure - lasts 30-90 s, motor seizure shorter than seizure on EEG
153
How to oxygenate with ECT after LOC?
Hyperventilate - bag until spontaneous ventilation resumes
154
what is the minimum seizure time?
25 s
155
What meds prolong seizure duration?
Alfentanil w prop aminophylline caffeine clozapine etomidate ketamine
156
156
what conditions prolong seizure duration?
Hypervent hypocapnia
157
what meds shorten seizure duration
Diltiazem Diazepam Fentanyl Lidocaine Lorazepam Midazolam Propofol Sevoflurane
158
Postop considerations with ECT:
Temporary cognitive/memory impairment like confusion, restlessness, agition for 30 mins may require restraints/benzo, antipsychotic, prop agitation may be due to increases plasma lactate levels due to inadequate MR
159
anterograde memory dysfunctiona fter ECT:
rapidly forget new info lasts a few days or weeks
160
Retrograde memory dysfunction post ECT:
Loss of memories form several weeks to months before tx
161
ECT postop considerations:
HA Muscle ache Nausea
NA 1
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